New heart rhythm fix sometimes short-lived

NEW YORK (Reuters Health) - A new procedure to treat the common heart rhythm problem atrial fibrillation may offer only short-lived relief for a significant portion of patients, according to California researchers.

Based on statewide data, they found 30 percent of treated patients were admitted to the hospital with the same problem within two years.

And one out of every 20 patients suffered complications during the procedure, such as bleeding, perforation of a blood vessel, or, rarely, stroke.

The procedure, called catheter ablation, is fairly new and hasn't been studied much outside clinical trials.

"As this kind of treatment gets widespread, we have to look at what happens in the real world," said Dr. Rashmee Shah, a cardiologist at Stanford University School of Medicine, who worked on the new study.

Around 2.6 million Americans have atrial fibrillation, in which the heart's upper chambers begin to quiver chaotically instead of contracting normally. It's not immediately life-threatening, but can cause distressing symptoms and may increase the risk of stroke.

Different drugs may be given to reset patients' heart rhythms or lower their heart rate, but they may not always work well.

Catheter ablation, in which a long tube is threaded through a blood vessel into the heart to remove the tissue that triggers the quivering, is gaining a foothold as an alternative to those drugs.

However, as an accompanying editorial notes, many such procedures are "commonly being performed by physicians lacking appropriate experience."

"As long as a hospital is able to profit from supporting interventional procedures by its physicians, there will be a tendency to set a low bar for granting privileges to any doctor who claims proficiency," writes Dr. David E. Haines, of the Oakland University William Beaumont School of Medicine in Royal Oak, Michigan.

The researchers studied medical records for more than 4,000 patients who'd been treated with the procedure between 2005 and 2008 in California.

They found that five percent had complications related to the surgery, and nine percent had to go back within a month. Ten patients suffered a stroke, four had lung collapse and one died.

Within a year, 22 percent of patients ended up back in the hospital with atrial fibrillation or a similar condition. One year later, the number had risen to 30 percent.

"Re-hospitalizations for atrial fibrillation are fairly frequent, but they are hospitalizations and hospitalizations are expensive," said Shah.

She cautioned that for the majority of the complications, it was impossible to say from the data how serious they were. She added that catheter ablation has been shown to improve some patients' quality of life more than drugs, although it hasn't been shown to help people live longer.

"If the patient is really troubled by their atrial fibrillation, they might still want the procedure," Shah concluded.